Clinicians and leading experts come together to address regional stroke divide

Stroke FoundationSep 13 2019

Australian clinicians and researchers are coming together with leading experts from across the globe to drive innovation and access to break-through blood clot dissolving and clot removal treatment.

Around 450 leading experts in stroke have come together at the National Convention Center in Canberra at Stroke 2019, the Stroke Society of Australasia‘s (SSA) 29^th Annual Scientific Meeting.

SSA President Professor Helen Dewey said stroke was treatable, however regional and rural Australians were being denied access to time-critical stroke treatments.

As clinicians and researchers, we are standing together to say survival from stroke should no longer be determined by where you live."

Professor Dewey, SSA President

Currently, regional and rural Australians are 19 percent more likely to experience a stroke than their city counterparts. Regional and rural Australians are also more likely to die or be left with significant disability as a result of stroke due to limited access to specialist treatment and care.

Innovations are extending treatment windows for stroke. Clot-dissolving treatment has now been shown to be beneficial up to nine hours from stroke symptom onset (up from 4.5 hours) and clot removal treatment has been shown to be beneficial up to 24 hours after stroke onset (up from six hours) in some patients.

Professor Dewey said we must ensure all Australians have access to these treatments. Clot-dissolving and clot removal treatment or reperfusion treatments, require specialist diagnosis and care,’’ she said.

“Our city hospitals are best equipped to deliver and support this, however advances in technology and extended treatment windows mean geography is no longer an excuse for denying regional and rural Australians the treatments they need.”

Stroke 2019 has brought together specialists in imaging, telehealth and reperfusion treatments to investigate and share innovative solutions to improve stroke treatment now and into the future.

Solutions to be discussed include the use of telehealth to increase access to emergency stroke treatment and rehabilitation, next steps for Australia’s first Mobile Stroke Unit or Stroke Ambulance, and future emergency response innovations including adapting the Mobile Stroke Unit model for a plane or helicopter.

We are working together to foster big picture solutions, as well as smaller changes we can make now at a local level to expedite access to time critical treatments. This includes improving systems and protocols at local hospitals, implementing prenotification tools that enable paramedics to communicate with hospitals, and using telehealth to boost capacity at our smaller hospitals while reducing unnecessary hospital transfers. When a stroke strikes it attacks 1.9 million brain cells a minute. With treatment this damage can be stopped, but every minute, every second saved equals brain saved."

Professor Dewey

Stroke Foundation Chief Executive Officer Sharon McGowan said the was an opportunity to improve the stroke outcomes in this country and called on Federal and State Governments to stand with clinicians, researchers and the community.

There is one stroke every nine minutes in this country. Stroke continues to kill more men than prostate cancer, more women than breast cancer and leave thousands with ongoing disabilities, yet stroke can be treated. The National Action Plan for Heart and Stroke, which is currently being finalized, sets out clear solutions to address this disease, including those being discussed at Stroke 2019. We have proven solutions to ensure equality of access to emergency stroke treatment, and clinicians and researchers are working to address this issue. However, for us to have a real impact, Governments must come together to address this disease."

Sharon McGowan, Stroke Foundation Chief Executive Officer

Ms McGowan noted the Federal and New South Wales Governments were working towards a Centralized Stroke Telehealth Service. Victoria has a fully operational Victorian Stroke Telemedicine Program and pilot telestroke projects were underway in South Australia and Western Australia.

Stroke 2019 international experts presenting new innovations from across the globe include:

• Professor Tudor Jovin - Professor of Neurology at the Cooper Medical School of Rowan University, Chairman of Neurology at Cooper University Healthcare and Director of the Cooper Neurological Institute: “How much imaging is needed to select acute stroke patients for thrombectomy?”
• Professor Lee Schwamm - Professor of Neurology at Harvard Medical School and Director of Acute Stroke Services at Massachusetts General Hospital, Boston: “From Randomized Trials to Clinical Registries: Translating evidence into practice improvement.”
• Professor Pamela W. Duncan – Professor of Neurology at Wake Forest University School of Medicine and Director of Innovations and Transitional Outcomes at Wake Forest Baptist Health: “Comprehensive Stroke Care: Is it time for a paradigm shift?”
• Professor Richard Aviv - Professor of Medical Imaging, Division of Neuroradiology, and Affiliate scientist, at the Sunnybrook Research Institute: “Multimodal CT imaging based selection of patients for acute stroke treatment.”